Abstract: Objective: To retrospectively review 5 cases of cervical necrotizing fasciitis associated with descending necrotizing mediastinitis (CNF/DNF), and to investigate the clinical characteristics and surgical treatment of this complex infection. Methods: Five patients, who underwent extensive cervical drainage, were identified from December 2012 to December 2016. Besides, two of them underwent the two-stage mediastinoscope drainage of mediastinum. Results: One patient was successfully treated after extensive cervical drainage, while other two patients who did not get efficient drainage of mediastinum were died of multiorgan failure related to septic shock. The rest patients who had undergone the two-stage mediastinoscope drainage of mediastinum were successfully treated. The mortality rate was 40%. Conclusion: High mortality is found in this complex infection. As it progresses quickly, prompt diagnosis and surgical treatment are essential for reducing mortality in CNF/DNM. Extensive cervical drainage and transthoracic drainage should be performed simultaneously without delay. Cervical drainage and mediastinoscope drainage is worthy of promotion.

Key words: Necrotizing fasciitis, Mediastinitis, Surgical treatment